T86.31

Billable

Heart-lung transplant rejection

HCC Category Mapping

V24HCC 186 — Major Organ Transplant or Replacement Status

0.910

ESRDHCC 186 — Major Organ Transplant or Replacement Status

0.000

RxHCCHCC 396 — Allograft Complications

0.000

What This Code Means

The recipient's immune system attacks and damages the transplanted heart and lungs, causing them to fail.

Coding Tips

•Document the timeframe of rejection (hyperacute, acute, or chronic) if available for clinical clarity
•Rejection is a common complication; ensure it is clearly documented in the medical record before coding

Clinical Significance

Heart-lung transplant rejection represents simultaneous rejection of both organs, creating a life-threatening emergency requiring immediate aggressive intervention to prevent dual organ failure and death. The complexity of managing rejection in both cardiac and pulmonary systems simultaneously requires specialized transplant expertise and intensive monitoring.

Documentation Requirements

✓History of heart-lung transplant with transplant date
✓Evidence of rejection in heart, lungs, or both organs
✓Biopsy results from endomyocardial or transbronchial sampling
✓Clinical symptoms affecting cardiac and/or pulmonary function
✓Pulmonary function tests and cardiac assessment results
✓Anti-rejection therapy protocols administered
✓Response to treatment and serial monitoring results
✓Coordinated care between cardiac and pulmonary transplant teams

Commonly Confused Codes

T86.30 — Unspecified heart-lung transplant complication (when rejection documented)T86.21 — Heart transplant rejection (single organ vs combined)T86.811 — Lung transplant rejection (single organ vs combined)T86.32 — Heart-lung transplant failure (active rejection vs end-stage)J44.0 — COPD with acute exacerbation (pulmonary symptoms)

Code Hierarchy

└T86Complications of transplanted organs and tissue └T86.3Complications of heart-lung transplant └T86.31Heart-lung transplant rejection

└T86.31Heart-lung transplant rejection